Knowledge of Vulvar Anatomy and Self-examination in a Sample of Italian Women

Abstract

Objective The aim of the study was to investigate the knowledge of vulvar anatomy and vulvar self-examination (VSE) in a sample of Italian women attending a gynecology clinic. Methods For this original research from May to July 2019, 512 women attending the Lower Genital Tract Clinic at the Department of Surgical Sciences of the University of Torino were invited to participate in a 29-question survey about vulvar anatomy, VSE, and sociodemographic details. Data were analyzed using descriptive statistics. Results Of 512 patients, 500 completed the questionnaire (98% response rate). The mean age of respondents was 41 years (range = 17–77 years). Education level was evenly distributed between elementary, high school, and university graduates. Only 15% of interviewed women were able correctly sketching vulvar anatomy. Seventy-six percent of the women had not heard about VSE, and 61% of the women approach their genitalia with feelings of shame and embarrassment. Only 23% of the women would seek medical advice after identification of possible abnormalities during VSE. A majority (69%) of the women would like to have more information about VSE and vulvar health through educational videos and social media. Conclusions Education about VSE may lead to earlier diagnosis of vulvar cancers and other pathologies. Further efforts are needed to disperse information about normal external female genital anatomy and VSE to achieve self-confidence among women.

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD) and the European Federation for Colposcopy (EFC) consensus statements on pre-invasive vulvar lesions

“…198 Furthermore, to achieve an effective vulvar examination, patients would need to collect images of their external genitalia, improving the vulvar self-examination, which could lead to an early diagnosis and treatment of vulvar pathologies. 176 Quality of life and psychological sequelae of vulvar preinvasive lesion treatment Pre-invasive vulvar lesions deserve specific attention because they affect not only functionality and body image but also psychosexual factors. Symptoms of intraepithelial neoplasia (ie, burning and itching), together with a change in appearance of vulvar skin, may cause dyspareunia and feelings of being less attractive.…”

The Impact of Vulvar Cancer on Psychosocial and Sexual Functioning: A Literature Review

“…Vulvar self-examination may allow women to have a healthier relationship with their genitals, overcoming the obstacles due to the feelings of shame, judgment and embarrassment. In fact, this is an easy procedure that takes only a few minutes and could change the clinical course of some pathologies and, in some cases, could save lives [ 9 ].…”

“…These two different biological entities also have a differing epidemiology, characteristics, and prognosis [ 5 , 6 , 7 , 8 ]. The diagnosis of vulvar cancer is often delayed, as there is not adequate awareness among women: the majority of women feel embarrassed to ask their physicians about vulvar health and vulvar symptoms [ 9 ]. VSCC is often asymptomatic for a long period of time, or it can present with pruritus, irritation, or pain.…”

The anatomical measurements of vulva in Indian women: A cross‐sectional prospective study

“…4 The need for these dimensions has arisen because many women do not know the exact anatomy of various vulval structures. Preti et al 19 demonstrated that only 15% of women were able to sketch their vulvar anatomy and about one-third of women had no idea about age, BMI, or ethnicity-related variability of the vulva. Lykkebo et al 20 found that the women who consider their genitalia abnormal had wide labia minora.…”